Many surgical procedures require access to the interior of a body. For example, to prepare a hip joint for an arthroscopic procedure, an access path must to be created to provide adequate access to the surgical site for an arthroscope and other instruments.
Some of the internal spaces in a body can be difficult to access. For example, a hip joint is considered to be more difficult to access and maneuver within than other joints for a number of reasons. Even at muscle relaxation during anesthesia, the joint space at the junction of the ball of the femoral head and the rim of the acetabulum maintains a strong vacuum force, sealed by the labrum and the capsular tissue (formed of muscular tissue and tendons constraining the joint). To allow surgical tools and instruments to access the joint space, it is required to apply force between the femur and the acetabulum to distract the joint. Once space is created in the joint, instruments are advanced through this thick, tough capsular tissue.
The conventional techniques for accessing internal spaces such as, for example, a hip joint space, involve inserting a needle, followed by a guidewire into tissue in the internal target space and then advancing a dilating tool over the guidewire into the target space. In this way, a dilator can be pushed over a guidewire into the hip capsule to access the hip joint. This technique can require the application of a significant force. Further, because of the difficultly in penetrating through the thick and tough capsular tissue into a narrow space within the hip joint, it can be challenging to advance the dilator toward the internal space without accidentally causing damage to articular cartilage. If an excessive force is used to advance the dilator toward the joint, iatrogenic damage can be caused by a tip of the dilator and/or by undesirably pushing the guidewire deeper into the capsule, such that the guidewire damages the articular surface of the acetabulum and/or femoral head.
Accordingly, there is a need for improved systems, methods, and devices for accessing interior body spaces such as an interior of a hip joint.